1. Intro to Urinary Flashcards
(18 cards)
1
Q
Functions of the kidney
A
- Excretion
- Regulation - fluid volume/ionic compounds
- Endocrine - renin and erythropoietin synthesis
- Metabolism -e.g. vitamin D to its active form
2
Q
Anatomical location of the kidney
A
- Retroperitoneum on the posterior abdominal wall
- Either side of the vertebral column
- Hilum at L1
- Located between T12 and L3
- Partially protected by 2 most distal costals (11/12)
- LHS is usually higher - liver pushes down on the LHS
3
Q
Layers surrounding the kidney
A
- Pararenal fat (in line with)
- Renal fascia
- Perirenal fascia (all around)
- Renal capsule
- Kidney
4
Q
Blood supply of kidney
A
LHS
• Left renal artery is more superficial than left renal vein
RHS
• Right renal vein is more superficial than right renal artery
- Arteries are direct branches of abdominal aorta
- Veins directly drain into inferior vena cava
- Renal artery
- Segmental artery
- Interlobar
- Arcuate
- Interlobular
- Afferent arteriole
- Glomerulus
- Efferent arteriole
- Peritubular capillaries
- Interlobular vein etc.
5
Q
Basic anatomy of kidney
A
- Medulla - contains majority of the length of the nephrons
- Cortex - erythropoietin synthesis and ultrafiltration at Bowman’s capsule
- Minor and major calyces - route of urine outside of the medulla
- Renal pelvis - urine storage
- Renal lobe - medullary section and associated cortex
- Renal pyramid - medullary section
- Segmental artery - branch of renal artery
- Ureter - exit kidney at hilum
6
Q
Difference between cortical and juxtamedullary nephrons
A
Cortical
• 85% of nephrons
• have a shorter LoH
Juxtamedullary
• 15% of nephrons
• have a longer LoH - more water is absorbed
7
Q
Anatomy of bowman’s capsule
A
- Afferent arteriole - arriving blood at Bowman’s capsule (BC)
- Efferent arteriole - exiting blood at BC
- Podocytes - large cells with foot like protrusions that prevent large solutes from leaving arterioles in BC
8
Q
Anatomy of nephron
A
- Bowman’s capsule
- Peritubular capillaries - around convoluted tubules
- Interlobular arteries - arteries between lobes
- PCT - reabsorb glucose and amino acids
- DCT - distal portion of nephron before the collecting duct
- LoH - ascending and descending limb
- Collecting duct - numerous nephrons empty urine into here
9
Q
Vasa recta
A
- Extended peritubular capillaries down the length of juxtamedullary nephron loop of henle
- Allow for more thorough reabsorption
10
Q
Juxtaglomerular apparatus
A
- When distal convoluted tubule contacts glomerulus
- Macula densa cells - sense how salty (osmolality) fluid in DCT is to determine blood flow in glomerulus
- They then signal to granular cells so they can produce renin if needed
- Extraglomerular mesangial cells - needed for signalling, stability of glomerulus and secretions
- These signal to podocytes to regulate filtration
11
Q
Left renal vein landmark
A
- Superior mesenteric artery superficial to left renal vein
- Celiac trunk more superior branch of aorta
- Inferior mesenteric artery more inferior branch of aorta
12
Q
Ureter
A
- Smooth muscle fibres that undergo peristaltic waves to propel urine to bladder
- 25-30cm length
- Retroperitoneal
- Lateral to transverse processes of lumbar vertebrae
- Travels beyond pelviureteric junction
- Most common point of ureteric injury is near the pelvic brim
13
Q
Ureteric bony landmarks
A
- L1 - hilum
- Lateral to transverse processes
- Crosses sacrum at sacro-iliac joint
- Ischial spine - where ureter kinks/bends towards the bladder
14
Q
Bladder
A
- Contain muscular folds (of detrusor muscle) called rugae - contract and expand
- Lined with transitional epithelium - urothelium (continuous with bladder, ureter and pelvic lining)
- When empty - bladder rests on pubic symphysis
- Can hold averagely 750ml
- Ureteric opening and internal urethral meatus - form trigone
15
Q
Oblique angle
A
- Ureter enters bladder at oblique angle posteriorly at vesicoureteral junction (VJ)
- Angle helps to stop reflux of urine
- When bladder is filled, it presses down on VJ - preventing any path for reflux
16
Q
Internal/external urethral meatus
A
- Internal - where urine exits bladder
* External - where urine exits the body
17
Q
How does urine exit bladder
A
- Initially leaves bladder at internal urethral meatus
- Enters urethra via internal urethral sphincter
- Urine is squeezed out pf urethra via urogenital diaphragm which contains external urethral meatus
- Urethra is short in females but longer in males
18
Q
Male urethra
A
- Prostatic urethra - portion that travels through prostate gland
- Membranous urethra - in line with urogenital diaphragm
- Bulbous urethra - bulbous appearance
- Penile/spongy urethra - surrounded by corpus spongiosum
- Navicular fossa - wider gap opened just before EUM
- External urethral meatus (EUM) - urine exits
